<div class="content page-payment">
		<ul class="menu">
			<li><a href="/cart.html">Mon panier d’achat</a></li>
			<li class="current"><a href="/payment.html">Paiement</a></li>
			<li class="back"><a href="/">Retour au site</a></li>
		</ul>
		<div class="introduce">
			<img src="/assets/images/img-payment.gif" align="left"/>
			<h2>Total du paiement: $<?php echo sumTotal();?> </h2>
		</div>
		<div class="clear"></div>
		<h3>Coordonnées</h3>
		<label class="ita">* Champs obligatoires</label>
		<form method="post" action="https://esqa.moneris.com/HPPDP/index.php" data-validate="parsley"> 
		<table width="500" border="0">
			  <tr>
				<td>Prénom*</td>
				<td><input type="text" name="bill_first_name" class="txt_info" value="" data-required="true"/></td>
			  </tr>
			  <tr>
				<td>Nom* </td>
				<td><input type="text" name="bill_last_name" class="txt_info" value="" data-required="true"/></td>
			  </tr>
			  <tr>
				<td>Entreprise/Organisation* : </td>
				<td><input type="text" name="bill_company_name" class="txt_info" value="" data-required="true"/></td>
			  </tr>
			  <tr>
				<td>Titre* :</td>
				<td><input type="text" name="note" class="txt_info" value="" data-required="true"/></td>
			  </tr>
			  <tr>
				<td>Courriel*	</td>
				<td><input type="text" name="email" class="txt_info" value="" data-trigger="change" data-required="true" data-type="email"/></td>
			  </tr>
			  <tr>
				<td>Adresse*</td>
				<td><input type="text" name="bill_address_one" class="txt_info" value="" data-required="true"/></td>
			  </tr>
			  <tr>
				<td>Ville*</td>
				<td><input type="text" name="bill_city" class="txt_info" value="" data-required="true"/></td>
			  </tr>
			  <tr>
				<td>Code postal* 	 </td>
				<td><input type="text" name="bill_postal_code" class="txt_info" value="" data-required="true"/></td>
			  </tr>
			  <tr>
				<td>Pays*	 </td>
				<td><input type="text" name="bill_country" class="txt_info" value="" data-required="true"/></td>
			  </tr>
			  <tr>
				<td>Province* </td>
				<td><input type="text" name="bill_state_or_province" class="txt_info" value="" data-required="true"/></td>
			  </tr>
			  <tr>
				<td>Téléphone jour* </td>
				<td><input type="text" name="bill_phone" class="txt_info" value="" data-required="true" data-type="number"/></td>
			  </tr>
			  <tr>
				<td>Cellulaire	 </td>
				<td>
				<input type="text" name="bill_fax" class="txt_info" value=""/>
				</td>
			  </tr>
			  <tr class="txt-agree">
				<td colspan="2"><input type="checkbox" name="chk_agree" class="txt_info check-address" value="" onclick="addinput()"/> Je veux entrer une différente adresse pour la livraison</td>
				
			  </tr>
			  
			  <tr >
				<td colspan="2" class="txt-addbox">
				</td>
			  </tr>
			  
			</table>
			<table width="535" border="0">
			  <tr><td colspan="2"><label class="kc">By continuing to the next step you agree to the Privacy Policy, return policy and delivery terms.</label></td></tr>
			  <tr><td colspan="2">
				<input type="hidden" name="ps_store_id" value="23EVBtore2"> 
				<input type="hidden" name="hpp_key" value="hpUN4FY3BQ4K"> 
				<input type="hidden" name="charge_total" value="<?php echo sumTotal();?>">
				<!--MORE OPTIONAL VARIABLES CAN BE DEFINED HERE --> 
				<input type="hidden" name="lang" value="fr-ca">
			  <input type="submit" name="btn_continue" class="btn btn-continue" value="Procéder &gt;"/></td></tr>
			</table>
			</form>
	</div>
	<!-- end content -->